Facility Evaluation Report

On 3/08/2024, Licensing Program Analyst (LPA) Melissa Spaeth conducted an announced Pre-Licensing visit to this facility and met with the Licensee. This is a new application and a fire clearance dated 12/07/2023 was received for five (5) non-ambulatory residents and one (1) bedridden resident. The facility phone number is 661-526-7051.

The purpose of today’s visit is to inspect the facility to ensure that it maintains compliance under California Code of Regulations, Title 22, Division 6. Component III was conducted with the applicant from 2:10 pm until 3:10 pm.

Today’s site visit consisted of LPA touring the physical plant inside and outside from 3:10 pm until 3:40 pm LPA Spaeth observed the following:

Living Room – The room contained comfortable seating and a television.

Kitchen/Dining Room - The facility contained a seven-day supply of non-perishable food and a two-day supply of perishable foods. The knives were locked in a kitchen cabinet. The cleaning solutions were locked underneath the kitchen sink. The medications will be locked in a kitchen cabinet. LPA observed the first aid kit was securely locked in the kitchen. Cleaning supplies were also locked in a kitchen cabinet. A fire extinguisher is also located in the kitchen. Appliances in the kitchen appeared to be functional. The dining room area contained a dining room table and chairs.